Despite these findings, there is no clear guidance on whether to withdraw DPP-4 inhibitors and add insulin therapy, or to combine these treatments INCB018424 nmr when intensification is required in patients with poor glycaemic control on metformin. Premixed insulin or basal insulin are often considered first-line
therapy options for patients with T2D requiring insulin treatment . Biphasic insulin aspart 30 (BIAsp 30) is a premixed insulin containing soluble insulin aspart and protamine-crystallized insulin aspart in a 30/70 ratio, thus providing prandial and basal glucose coverage, respectively, that can be administered
once, twice or three-times daily. Adding BIAsp 30 Ixazomib mw has demonstrated significant improvements in glycaemic control versus OADs alone in poorly controlled insulin-naïve patients with T2D ,  and ; however, clinical data on the combination of premixed insulins and sitagliptin are limited. The Sit2Mix trial aimed to investigate efficacy and tolerability of intensifying diabetes treatment with once- or twice-daily BIAsp 30 by either adding BIAsp 30 to sitagliptin or substituting BIAsp 30 for sitagliptin in patients with T2D
inadequately controlled on sitagliptin and metformin. Sit2Mix was a randomized, open-label, three-arm, parallel-group stratified, multicentre trial conducted in Argentina, Australia, Brazil, Greece, India, Korea, Malaysia, Portugal, Thailand and Turkey between 2012 and 2013. A 2-week screening period was followed by a 24-week treatment period during which patients were randomized diglyceride (1:1:1) to BIAsp 30 (NovoMix 30, Novo Nordisk, Bagsværd, Denmark) administered twice daily + sitagliptin + metformin (BIAsp BID + Sit), BIAsp 30 administered once daily + sitagliptin + metformin (BIAsp QD + Sit), or BIAsp 30 administered twice daily + metformin but without sitagliptin (BIAsp BID). Participants were stratified according to prior OAD treatment besides sitagliptin and metformin. All other OADs were discontinued at randomization. The trial was conducted in compliance with Good Clinical Practice, local regulatory requirements and the Declaration of Helsinki. Participants were eligible for inclusion if diagnosed with T2D for ≥6 months before the study, ≥18 years of age, HbA1c 7.0–10.0% and BMI ≤40.0 kg/m2.